Soft tissue structures, such as fibrocartilage, ligaments and tendons, facilitate connections between multiple anatomic components. Injuries can partially and/or completely sever such structures leading to immobility and/or dysfunction of the anatomic components. In one example, a shoulder injury may tear a portion of the rotator cuff from its connection to bone, leading to instability of the shoulder joint and causing the naturally tensioned tendon to slacken. In another example, a shoulder injury may separate a portion of the glenoid labrum from the underlying bony structure leading to joint instability.
In some instances surgery may be needed to repair or replace the damaged soft tissue, which often involves anchoring the tissue in its natural position until fully healed. Traditionally, this was achieved by tethering the damaged tissue with a filament to a metal or hardened polymer anchoring device fixed to a bony structure. However, in many instances, such traditional anchoring devices tend to be large in diameter, and must include sufficient material, or other additional structures, to withstand pullout forces. The size of such devices may limit implantation locations in the body, as sufficient bone mass is required to accommodate the device.
Recent trends in tissue anchoring have seen the emergence of “soft” devices, also referred to as “filamentary” fixation devices, in which the anchoring device itself may be constructed of filamentary material, such as suture or the like. Despite the many benefits these filamentary fixation devices provide, such devices, to date, cannot be used to perform knotless surgical procedures, that is, surgical procedures using filaments (such as sutures or the like) where the filament is secured without the need of tying knots, such as half hitches or the like. Further, such devices, while generally capable of being anchored in a smaller bone hole than traditional anchoring devices, may still require a hole too large for certain applications.